Abstract
AbstractBackgroundCognitive intervention has been shown to be effective to delay cognitive decline in older adults with dementia. However, whether cognitive intervention could be effectively delivered in individual, group, telephone, guided self‐help and unguided self‐help formats remains unclear. This study aims to compare and rank the efficacy of five cognitive intervention delivery formats for older adults with dementia in improving their cognitive function.MethodPubmed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), CINAHL, the Cochrane Central Register of Controlled Trials, Web of science, China National Knowledge Infrastructure database, Chinese Biomedical Literature database and Wan Fang database were systematically searched. Randomized controlled trials (RCTs) that compared the differences between different cognitive intervention delivery formats or any one of the five delivery formats with a control group in treating older adults with dementia were identified and included. The Cochrane Risk of Bias tool was used for critical appraisal. Pairwise meta‐analysis was conducted to directly examine the efficacy of each cognitive intervention formats. Network meta‐analysis (NMA) was conducted to evaluate the relative effects and rank probability of different cognitive intervention delivery formats.ResultTotally 51 studies were included which enrolled 3388 participants. Compared with the control group, the mean difference (MD) of guided self‐help [MD = 2.48, confidence interval [CI]: (1.45, 3.53), group (MD =1.21, CI: 0.14, 2.28), individual (MD = 1.63, CI: 0.86, 2.4) could significantly improve cognitive function measured by Mini‐Mental State Examination (MMSE), while telephone (MD =2.89, CI: ‐1.41, 7.15) and unguided self‐help (MD = 2.06, CI: ‐0.29, 4.41) were not significantly inferior to control condition. Guided self‐help had the highest probability of being the best treatment among the five cognitive intervention delivery formats [the surface under the cumulative ranking curve (SUCRA= 85.13%)], followed by individual (SUCRA = 78.14%) and group (SUCRA = 77.68%).ConclusionFor older adults with dementia, guided self‐help, group and individual cognitive intervention delivery formats appeared to be effective in improving the cognitive function. Health‐care professionals should apply personalized cognitive intervention format based on individual condition and preferences.
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